利格列汀联合预混胰岛素治疗T2DM疗效观察  

Effi cacy of linagliptin combined with premixed insulin in the treatment of type 2 diabetes mellitus

作　　者：白进军[1] 陈静[1] 郭玉红[1] 刘宇明[1] Bai Jinjun;Chen Jing;Guo Yuhong(Aerospace 731 Hospital,Beijing 100074)

机构地区：[1]中国航天科工集团七三一医院肾病内分泌科,北京100074

出　　处：《中国现代医药杂志》2018年第10期31-33,共3页Modern Medicine Journal of China

摘　　要：目的观察利格列汀联合预混胰岛素治疗T2DM的疗效。方法选择符合条件的68例T2DM患者,在预混胰岛素治疗的基础上,加用DPP-4抑制剂利格列汀(5mg,qd)治疗12周,观察治疗前后患者的总体疗效及相关生化指标的变化。结果利格列汀联合预混胰岛素治疗12周后,患者的FPG、2h PG和Hb A1c分别由(9.20±2.90)mmol/L、(14.80±3.80)mmol/L、(8.98±1.12)%下降至(6.60±0.60)mmol/L、(8.21±1.22)mmol/L、(7.11±0.81)%(P<0.05),达标率(Hb A1c<7.0%)由14.71%增至58.82%(P<0.05),胰岛素用量由(58.66±25.62)U/d下降至(40.20±22.25)U/d(P<0.05),TG和β2-MG分别由(4.02±1.91)mmol/L、(3.88±0.65)mmol/L下降至(2.20±0.91)mmol/L、(3.01±0.52)mmol/L(P<0.05);治疗前后患者体质指数及LDL、ALT均无明显变化(P>0.05);治疗期间,有6例患者发生轻度低血糖事件22次,均出现在联合治疗的前10d,无中重度低血糖事件发生;仅3例患者治疗初期出现胃肠不适,但均能耐受,无一例退出治疗。结论利格列汀联合预混胰岛素治疗T2DM可有效降低患者空腹及餐后血糖水平,HbA1c达标率升高,且不增重,患者依从性良好,无明显不良反应,无严重低血糖事件发生,同时可改善患者血脂及肾功能,不影响肝功能。对于使用预混胰岛素而HbA 1c仍不达标的T2DM患者联合使用利格列汀,在联合治疗的前10d需频繁监测血糖,并及时调整胰岛素用量。Objective To observe the effect of linagliptin combined with premixed insulin in type 2 diabetes mellitus patients.Methods 68 patients with type 2 diabetes mellitus treated with premixed insulin accepted linagliptin(5mg,qd)for 12 weeks.Observed the overall curative effect and biochemical changes before and after treatment.Results 12 weeks after treatment,the fasting plasma glucose(FPG),2h postprandial blood glucose(2hPG)and glycosylated hemoglobin(HbA1c)were significantly lower than those before treatment,down from(9.20±2.90)mmol/L,(14.80±3.80)mmol/L(,8.98±1.12)%to(6.60±0.60)mmol/L(,8.21±1.22)mmol/L(,7.11±0.81)%,respectively(P<0.05).And the target rate(HbA1c<7.0%)increased significantly from 14.71%to 58.82%(P<0.05),the dosage of insulin decreased significantly from(58.66±25.62)U/d to(40.20±22.25)U/d(P<0.05),and the levels of TG andβ2-MG decreased significantly from(4.02±1.91)mmol/L(,3.88±0.65)mmol/L to(2.20±0.91)mmol/L(,3.01±0.52)mmol/L,respectivel(yP<0.05).There was no significant change in BMI,LDL and alt before and after treatmen(t P>0.05).During the treatment period,there were 22 mild hypoglycemia events in 6 patients at the first 10 days of treatment.No moderate and severe hypoglycemia events occured.Conclusion Linagliptin combined with premixed insulin can effectively reduce fasting and postprandial blood glucose levels in patients with type 2 diabetes,and help to achieve the standard of HbA1c,but does not increase the weight of patients,and the patients have good compliance and no obvious adverse reactions.There was no serious hypoglycemia event,it can improve blood lipids and renal function and liver function was not affected.Type 2 diabetes patients who used premixed insulin and HbA1c was still not up to standard could be treated with linagliptin.Blood glucose should be monitored frequently and insulin dosage should be adjusted at the first 10 days of treatment.

关 键 词：利格列汀 预混胰岛素 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]